The Preparation I Never Knew I Needed: Chronic Illness and Pregnancy

Okay, I'm going to try fit pregnancy and birth into one blog post - I hope for you readers that this goes well, good luck.

So, let's split it up - my pregnancy journey and the us and downs, my arthritis, how my chronic illness prepared me for pregnancy, pregnancy hacks, the whirlwind of giving birth and everything in between!

Spilling the beans, first trimester and the dreaded sickness are all in my "Growing Life in a Tired Body" post - see here https://www.underyoungskin.com/post/growing-life-in-a-tired-body .

I then briefly spoke about the struggles of pelvic girdle pain in my London post which covers until June - see here https://www.underyoungskin.com/post/hot-bothered-and-expecting-london-in-a-heatwave .

So, the rest of the story:

Once the nausea and sickness began to subside around 16 weeks, I started experiencing pain in my hips and pelvis. Initially, I thought I had simply overdone it, so I took a couple of days off work to rest. However, rest barely made a difference, and even short distances became unbearable. Due to frequent absences and constant pain when I was at work, I decided to take sick leave starting in May and begin my maternity leave early. I touched on this in a previous blog post, where I was still grappling with the decision and trying to convince myself it was the right choice.. Now that we have our gorgeous boy, I know for sure that nothing else mattered and it was indeed the right decision. From that point until giving birth, my focus was on pacing myself and taking care of both of us. I started using crutches for anything beyond short trips between the house and car. It felt like such a failure but made all the difference and definitely needed.

Once I wasn't going into work, I was able to pace out my days and really start looking after myself. I ensured I got out of the house every day, taking short walks, attending pelvic health physio and made sure I did my exercises and tried to make sure I did as much as I could to get myself to the end of pregnancy and to give birth. One thing that got me through this was when I started to feel him kick, reminding me it was all worth it. The midwives discussed the possibility of early induction from 38/39 weeks - which all the way through the pelvic girdle pain I thought I wanted it. But once I hit 37 weeks, the pain plateaued - making it feel like it got better because it had just been getting worse since week 16 so I was constantly expecting worsening symptoms. I think also the reality kicked in that these would be the last weeks before our lives changed forever. I felt like I just wanted it to happen naturally and didn't mind waiting (within reason)! That said, we had to go into MAC because of reduced movements and I was induced at 39 weeks and had him in the next couple of days. Though I didn't end up waiting as long as I thought I would, I was just relieved and excited to finally meet my baby.

My Arthritis:

Arthritis wise, probably the best year since diagnosis.

Before getting pregnant, I had heard mixed experiences—some women go into remission, while others face worsened symptoms. I really didn't know what to expect.

I spoke before about thinking this was maybe why I was able to do so much walking without trouble on our honeymoon and I think for the first time ever (and probably the last) I have my hormones to thank for that. I don't know how it works with hormones and why some go into remission when pregnant - why, if this can happen, does our body attack itself in the first place? It doesn't make sense to me, but I wasn't complaining!

Through the first trimester when I still could move about fine, I still struggled with bending/squatting with my knees - but just pain, no swelling. I continued my injections until I was about 25 weeks. After discussions with my Rheumatologist, we decided I could conservatively manage my condition until after birth, given that I hadn't experienced a significant flare for a long time. The hope was to delay biologics after birth for as long as possible, but I had to resume them in January.

The Experience of Pelvic Girdle Pain:

I don't even know how to explain this - distinctly different from arthritis pain. Initially, it manifests as a painful pulling sensation. The stiffness feels unlike anything I've experienced before, as if my pelvis is being simultaneously pulled apart and fused together, offering no relief regardless of my position—be it sitting, standing, walking, or lying down. I'm eager to hear any tips for finding comfortable positions, as I struggled to find even one. By the end of pregnancy, when walking even with taking small steps and using crutches, the pain got unbearable.

How my chronic illness prepared me for pregnancy:

Slowing down - With the sickness, I tried to stay at work as much as possible but there's really not much you can do and you have to face the fact that you can't work. That bit felt relatively easy compared to the next. With the pelvic pain, it was much harder. I was used to having to make adjustments at work and for a while, these worked. But unlike a flare-up, I knew this was going to be difficult for the whole time I was pregnant and at the time I was working in outpatients so I really felt like I was letting my patients down as the appointments had to be cancelled. I found myself off work more often than not and work needed a plan in place to make sure patients were still being seen. Recognising that I needed to slow down for both myself and my baby made the decision clear. Initially, it was a difficult time, and I struggled with feelings of failure. Yet, as the pain intensified during my time off, it became evident that I could not have continued working. This was the only moment I felt let down by the maternity services during my pregnancy. I had requested mental health support but did not receive a response for several months, by which time I had already begun to cope on my own.

Pacing: A Balancing Act - With the gift of time on my side during my time off work, I was able to get outside and soak up the sun and let myself relax. I was also very lucky to have the support network I do so the days didn't get lonely. No matter how much practice I've had with pacing and balancing the peak and troughs, I often found myself pushing too hard on the good days and suffering later. This is definitely something I think everyone learns the hard way. It's easy to plan but it's the guilt of not doing enough that gets into your head and ruins those plans. I think if I wasn't used to pacing, this would've been really hard and I would've done myself a lot more damage.

Asking for help, embracing vulnerability - I have spent the last 9-14 years learning this skill, and yes, it is a skill. It makes you feel vulnerable, useless, weak. But really, it's a strength. There’s no shame in reaching out for support; the people in our lives genuinely want to help, just like you want to help them when they are in need. But it takes time and lots of practice - and even then, it can be a challenge. This ability to ask for help is especially crucial during the postpartum period, as having a solid support network can make all the difference. Remember, you are not alone in this journey, and seeking help is a sign of courage, not weakness.

The constant worry:

As I have said in pretty much all my blog posts - one of the biggest parts of having a chronic illness is the constant worry of the unknown, the anxiety and anticipation of what's going to hit you next and how you're going to be able to cope.

Adding this to the typical pregnancy anxiety means you're constantly at war with yourself in your head. It's not just the worry of whether you will flare while you're pregnant; you're now thinking way into the future and worrying about every single step of your child's future and how your condition will affect them. Obviously, I thought about this a lot before I got pregnant but, like with most things, once you're in it, it feels different. My biggest worry was not being able to look after my baby because I was flaring. I know I have an amazing husband, family and friends and I would never be on my own, but that's not the point. I felt like I couldn't prepare as it was so unknown. My flares now won't just affect me - and that's scary. I knew I always wanted to breastfeed but I decided I would also express as well so that feeding wasn't always on me. This helped take the pressure off a little. And it turns out breastfeeding didn't go too well anyway and I ended up exclusively expressing for 4/5 months. I feel that although this wasn't as I had planned, maybe it was meant to be. It meant other people could take him and I could rest with less guilt (in some respects). Baby was fed and happy and that's all that matters. The worry will never end, and I guess that's just part of parenthood. The tablets definitely help, though!!!

My best pregnancy hacks:

• Stay Cool:  If you're a summer preggo, get yourself a handheld fan. And don’t forget about a larger fan or air conditioning for those sweaty nights during heatwaves!

• Hydration is Key: Grab a big water bottle—maybe even two! With "pregnancy brain" in full swing, it’s easy to misplace them. Keeping hydrated is essential for you and your little one!

• Silky Sleep: For easy rolling through the night, wear some silky pj shorts. I had to get a pregnancy pillow for comfortable side lying because I was constantly repositioning onto my back in my sleep - a pillow between the knees also helps the hip pain!

• Heat Relief: If you're dealing with pelvic girdle pain (PGP), a heated blanket or a wheat bag to ease discomfort. Your body will thank you!

• Avoid Stairs: A joke but, take it easy. One step at a time. If you get bad PGP this isn't even a choice it's a necessity! It's worth the extra time it takes.

• Indulge in a Pregnancy Massage:  If your body feels like it’s breaking down, treat yourself to a pregnancy massage after the first trimester. It may take a few tries to find the right therapist, but it’s a heavenly experience!

• Let Go of Unwanted Advice:  Ignore the "Karens" of the world and their unsolicited opinions. Acknowledge their words, then let them drift away—your peace of mind is far more important!

• ACCEPT HELP:  This cannot be stressed enough! Embrace the support from friends and family. You deserve all the help you can get during this incredible journey!

Remember, each pregnancy is unique, and it’s all about finding what works best for you. Cherish this time, listen to your body, and don't feel guilty if you don't love every second of it - it is hard work.

So to sum up, pregnancy is wild. Honestly, WILD.  From the whirlwind of quirky symptoms to the miraculous fact that your body is nurturing and creating life. I have been around lots of pregnant women and of course all the animals but it still just astounded me every single day.

Remember to take it easy—your body is performing an extraordinary feat. It’s working tirelessly to bring new life into the world, and you deserve all the gentleness and care during this time.

Although it may sound strange, I'm thankful for what my chronic illness has taught me. It gave me the resilience to survive the hardship of pregnancy, maybe it was just training all along. I'm also VERY thankful my arthritis behaved whilst I was pregnant.

Is birth the easiest part of motherhood?

As I mentioned earlier, I had been talking with my midwife about early induction pretty much since the PGP started but when I got to 37 weeks I decided that I'd at least wait until 40 weeks before making a decision about induction. I don't know where the feeling came from but I changed my mind and just wanted him to come naturally. Anyway, my little man had other ideas.

On the Sunday morning before we had him, I noticed reduced movements and went into MAC. After being monitored, the staff were happy for me to come home and with everything into consideration, they scheduled an induction on the following Friday, but to go back anytime if I still felt things weren't right. I’m so grateful I listened to my instincts. That evening, I returned to the hospital, and they decided to keep me overnight for further observation. The monitors showed slightly reduced movements and a dip in his heart rate, which was concerning. Trusting my gut was undoubtedly the right choice.

By Monday morning, the consultant made the decision to move my induction to Tuesday instead. I was relieved to be able to spend one more night in my own bed on Monday night—it felt like a small but precious gift amidst the whirlwind of emotions. The mix of excitement, anxiety, and the surge of hormones was truly overwhelming. Each moment was a rollercoaster.

Tuesday morning arrived with a mix of anticipation and uncertainty as we went to the hospital, not quite sure how long we would be there. The procedure can involve three pessaries administered 24 hours apart to induce labour. The waiting game had begun. Fortunately, the weather was lovely, allowing us to take a stroll around the hospital grounds and sit in the gardens - where I spent most of my lunch breaks for the last few years at work! That evening for our takeaway tea we tried a spicy burger just to see if it would hurry anything along - unfortunately it was too spicy and I couldn't even finish it. After an uncomfortable nights sleep, another day of waiting until the pessary was changed that afternoon. I was hoping to go down to meet some work friends on the ward or in the canteen but my hip pain had ramped up. The midwives made sure I was topped up with codeine and paracetamol and I spent a lot of the day on the exercise ball trying to find some relief. I'm so glad Dan was able to stay with me the whole time, the boredom and cabin fever hit hard very quickly. When the midwife changed the pessary, she said I was only dilated 1cm and it looked likely that I'd need a 3rd pessary the next day.

Anyway, a few hours later the hip pain got worse and came in waves and started to coincide with some cramps - I told the midwife and she said it might be the start. I was thinking how on earth does this get more painful - but all in my hips. It was at this point that one of the midwives told me that you can get contractions in your hips - so turns out I'd been having them since the morning, I just didn't know they were contractions!!! Not long after, my waters broke and I was sick all over the bathroom! The pain escalated and I asked the midwife if she was able to give me an epidural. Typically, this was just at handover time but luckily the midwife that was on the night before was on the labour suite that night so there were able to quickly transfer me and I had the epidural in no time. They also gave me some gas and air which made me high as a kite and I was either asleep or talking shite.

The midwife had just reassured Dan that he could catch a couple of hours of sleep before the real action began. But just ten minutes later, everything changed—I was fully dilated and ready to push! The challenge of pushing while under the effects of the epidural was tougher than I had imagined. I can't remember how long I was trying for and then his heart rate started to drop so they decided they needed to get me into theatre. Signing the consent forms whilst high as a kite was an interesting experience. A load more drugs, the anaesthetists talking about her caravan holidays, me fainting and being sick again, an episiotomy and forceps later and our baby boy was here - an entrance of pissing all over my face! And I was so out of it after cuddling him for a few minutes I still had to ask Dan again if it was a boy or girl!

When we returned to our room, Dan cuddled him in his arms and we exchanged glances, both thinking he looked like a little Walter—our Walter.

As I held him against my chest, skin to skin, it was nothing short of magical to witness his instinctual nuzzling as he sought to latch on. I know I've seen hundreds of animals do it so naturally but to see it like that and feel it was just amazing. Unfortunately, I didn't get my tea and toast for another like 6 hours so it didn't have the same effect as expected. When I was finally able to walk again, I waddled to the bathroom feeling very vulnerable and obviously very sore, but so incredibly grateful. We spent the next couple of nights in the hospital just to make sure everything was okay and for me to feel comfortable with feeding - unfortunately, this wasn't the case for long. It felt like we had been in the hospital forever due to the induction, so the moment we finally headed home was a breath of fresh air! And just like that, we were thrown into the wonderful chaos of figuring out life with our new baby.

I have such mixed feelings about my pregnancy and found it so hard to not compare myself to others - something as humans we're not good at despite how much we advise others to. But most importantly - we have our baby boy, safe and sound.

I would love to hear others' experiences on chronic illness and pregnancy - and then the next part, chronic illness and parenthood!

Head to my Instagram @alidaggett for the videos on my pregnancy journey - the ups, downs and all the crazy!!

As always, thank you for reading,

Ali x